Morphological Changes of the Human Bone Marrow before and after BoneMarrow Transplantation : An Electron Microscopic Study

学位の種類: 博士（医学）. 報告番号: 甲第1044号. 学位記番号: 新大院博（医）甲第728号. 学位授与年月日: 平成7年3月23日新潟医学会雑誌. 1995, 109(3), 112-121.Bone marrow transplantation (BMT) has been long carried out for many patients with hematological malignancy. However, few reports have been available concerning the ultrastructural changes of marrow stromal cells (non-hematopoietic cells) before and after BMT. In the present study, the bone marrow from six patients was examined under an electron microscope on the day of BMT and at following stages. The findings on the day of BMT were supplemented by observation of the bone marrow from irradiated rats. In the bone marrow after irradiation and administration of cytotoxic drugs, there were surviving stromal cells consisting of reticular cells, endothelial cells, macrophages and fat cells. This finding supports a generally accepted idea that the stromal cells are important for homing and proliferation of transplanted hematopoietic stem cells. However, network of reticular cells and vascular arrangement of endothelial cells were severely damaged by chemo-radio-therapy before BMT. It is doubtful that such stromal cells maintain the hematopoietic microenvironment for homing of transplanted cells. Enlargement of lipid droplets in fat cells was commonly found in humans and rats. Ultrastructure of the bone marrow at recovering stages after BMT differed among patients. In cases with hematologically sound recovery, the bone marrow revealed ultrastructure similar to that in normal marrow. In contrast, in cases with hematologically poor recovery, reconstruction of the stromal cells was incomplete even more than 28 days after BMT. This finding suggests that reconstruction of the stromal cells is intimately related to the hematological recovery of the bone marrow.博士（医学）新潟大